International Journal of Advanced Engineering Research and

Science (IJAERS)
Peer-Reviewed Journal
ISSN: 2349-6495(P) | 2456-1908(O)
Vol-10, Issue-3; Mar, 2023
Journal Home Page Available: https://ijaers.com/
Article DOI: https://dx.doi.org/10.22161/ijaers.103.8

Humanization in Undergraduate Medical Education: The

Brazilian Learner’s Perspective
Vera Lúcia Lameira Picanço, Gabriela de Barros Melo, Guilherme Alves da Silva, Marcos Alberto
Figarella de oliveira, Edilene soares da silva, Juliana dos Santos Tartáglia, Gabriela de Lyra Sousa,
Danielle Lima Barbosa, Marcela Magno Miranda Bezerra, Igor Florenzano Wanzeler, Dienyelle de
Nazaré Costa Barbosa, Carolynne Lima de Sousa, Larysse Moura Moreira, Maria Jessica Alves
Pinheiro, Gabriela Mutran dos Anjos, Samuel João dos Santos Santana, Felipe de Paula, Camylla
Rebbeca Bezerra de Aragão, Gabriel Carvalho de Oliveira, Matheus Albert de Souza Puerro, Aysha
Nayane Lisboa Franco, Anna Luiza Fonseca Siqueira da Silva, Ana Laura Nobre e Nobre, Isabela
Blosfeld Mansour, Heloisa Pamplona Boulhosa, Luíza Pinheiro Nascimento, Edilson Pamplona
Boulhosa, Camila Sisnando Faustino, Patricia Benitez Sousa, Adrianne Raposo Ponte, Renan Reno
Martins, Luciana Saliba Mohana Alencar, Danielle Moura Nunes, Mariana Abucater Couto, João Victor
Tavares da Costa, Paulo Matheus Sherring e Sousa, Gabriela Blanco de Morais Trindade, Juliana Prusch
Fernandes Cardoso, Renata Barros de Lira, Ingrid de Paula Costa Pereira, Brenda Michelly da Silva
Carvalho, Igo Eduardo Corrêa de Oliveira, Rosivete Figarella de oliveira, Ricardo Silva De Sousa
trindade, Pâmella Yumi Taniyama Dantas, Júlio César Soares Lorenzoni, Marília de Jesus da Costa Sá
Pereira, Rosa Lorena Mendes, Carla Dulcirene Parente Novaes, Joelma Bello de Barros , Letícia
Amanda Pinheiro de Ataíde, Jamilly Gonçalves Zani, Caroline Cabral Lorenzoni, Daniela Delgado
Carvalho Ramos, Pedro Luan Dos Santos Dias

Received: 05 Feb 2023, Abstract— The production of humanized health should consider the
Receive in revised form:03 Mar 2023, individual as a whole, taking into account their particularities and
perspectives, in order to promote care with ethical, humanistic and
Accepted: 10 Mar 2023,
clinical quality. The objective of this study is to evaluate, from the
Available online: 19 Mar 2023 perspective of medical students, their perceptions and knowledge
©2023 The Author(s). Published by AI regarding humanistic training during medical school. This is a
Publication. This is an open access article under quantitative and qualitative exploratory research in the strict
the CC BY license methodological sense of keeping the focus, the object of study, which
(https://creativecommons.org/licenses/by/4.0/). was made with the students of the Medicine course from the second to
the tenth periods of UNIFAMAZ, enrolled in the first semester of 2019.
Keywords— Humanization, Medical
As an instrument of data collection, the structured questionnaire was
Humanities, Student, Medical Education.
used, and data obtained transcribed into LibreOffice®, elaborating the
corpus for data processing. IRAMUTEQ was used for processing the
text corpus. Regarding the absolute frequency of the words within the
text corpus, evidence was obtained of the main terms: Patient
(frequency of 86), doctor (frequency of 70), care (frequency of 44),
empathy (frequency of 48), professional ( frequency of 34), important(
frequency of 35), human (frequency of 33), humanized (frequency of
25), relationship (frequency of 17), physical (frequency of 17), health
(frequency of 25), treat (frequency of 15), treatment (frequency of 12),
In most of the questionnaires these words considered high frequency,

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Beltrão and Soares International Journal of Advanced Engineering Research and Science, 10(3)-2023

were exposed by the students, correlated with the true meaning for him
of a good humanized care. In short, the insertion of the teaching of
humanized medicine in the undergraduate course exerts on the student
and future professional a reflective, motivational and conductive power
about the subsequent medical practices.

I. INTRODUCTION may compromise health service users. One of its highlights

Humanization is a process that can occur in several is the incessant work to combat any kind of violence
areas, however, here the focus will be on health sciences, generated by mistreatment, whether physical or
specifically in the formation and performance of the psychological.
physician. The term "humanization" is widely discussed in Currently, in Brazil, the training of medical
health services and refers to several concepts, historical students is determined by the National Curriculum
origins, and even different lines of thought, which allows Guidelines of the Ministry of Education (BRASIL, 2014, p.
for several interpretations about it. According to Barros and 10) and medical schools have introduced in their
Passos (2018), for the dictionary of professional education Pedagogical Projects integrating axes, among them the
in health: Humanization, in the field of public health Medical Humanities, articulated to clinical practice. In the
policies, refers to the transformation of models of care and National Curriculum Guidelines for the Undergraduate
management in health services and systems, indicating the Course in Medicine (DCNM), it is precisely stated in art. 3
necessary construction of new relationships between users that the physician upon graduation should have the
and workers and among them. following profile:
Humanization in health care is focused mainly on The Medicine graduate will
the production of health, observing the subject as a whole, have general, humanistic,
in order to assist him in a very personal way, contemplating critical, reflective and ethical
not only the disease as a causal factor, but its entire history, training, with the ability to act
with the purpose not only investigative, but in order to at different levels of health
promote the desired health, offering the patient or user a care, with actions to promote,
service with ethical, humanistic and at the same time, prevent, recover and
technical quality (BARROS; PASSOS, 2018). rehabilitate health, at
There are many obstacles to the implementation of individual and collective
humanized health care in Brazil. Among them, the levels, with social
precarious conditions of care that both the professional and responsibility and commitment
the patient are exposed to, the lack of material in health to the defense of citizenship,
units, as well as the long working hours that professionals human dignity, integral health
are subjected to, which makes their work increasingly of the human being and having
exhausting, make this process even more difficult. The lack as transversality in its practice,
of humanity can be seen from the moment the patient tries always, the social
to make an appointment, as well as in the long lines that determination of the health and
form on the day of the service. disease process (BRASIL,
2014, p. 11).
When humanization occurs, it creates better
conditions for those who perform health care functions and One realizes that in order to transform health, it is
also for the people who seek care. Observing this, in 2003, necessary to make changes in the construction process of
the Ministry of Health launched the National Humanization the subjects of these practices. This will only be possible
Policy (PNH), with the goal of seeking to put into practice through the necessary qualification of professionals who
the principles of the Unified Health System (SUS) in the become protagonists of this history. The Centro
daily lives of health services, producing effects on the ways Universitário da Amazônia (UNIFAMAZ), has inserted in
of serving and caring for people (BRASIL, 2014, p. 10). its Pedagogical Project of the Medicine Course (PPCM) in
its curricular matrix, since its implementation, among
The NHP acts by facilitating and stimulating the
others, the axis Medical Humanities, with the objective of
relationship between managers, workers, and users,
forming doctors with a humanistic view and prepared to act
decentralizing the hierarchization of competencies with the
in the job market. This axis contemplates a:
purpose of inhibiting inhumane activities and practices that

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Beltrão and Soares International Journal of Advanced Engineering Research and Science, 10(3)-2023
It will be developed by
modules organized in themes
in the areas of humanities,
human rights, cultural
diversity, ethics, bioethics,
social aspects of health
problems, communication of
bad news, patient safety, and
other themes focusing on
respect for the human being
and related to the formation of
doctors in an interdisciplinary
approach, sustained in a
process of knowledge
construction using active
methodologies. The modules
take place from the 1st to the
4th period. It is an axis that
articulates with the modules of
the IESCG, HC, and in the
periods. Each module has 02
weekly hours, totaling 40 hours
in the period, with relevant
themes for the humanistic
formation of the medical
professional. The definition of
the contents is done through
meetings and workshops,
where the teachers prepare the
planning for the period. From
there, the objectives of the unit
are outlined (BRASIL, 2014, p.
11).
It is necessary to train health professionals for
society to act as facilitators of the healing process, ensuring
not only the satisfaction of the patient who seeks relief, but
above all to see him as a human being.
II. JUSTIFICATION
The humanization of medicine is a very popular
subject nowadays; today we seek a medicine based on the
person and not only on the disease. Physician Gregorio
Marañón was one of the main defenders and systematizers
of the so-called personalist medicine (1887-1960). He listed
the humanities as one of the five sources of medical
knowledge and classified it as essential for a medicine
centered on the person, presenting itself as a facilitator for
the physician to enter the patient's personal dimension.
Considering and valuing the findings of science is
essential to medicine; however, never before has so much
been said about the need to humanize medicine and medical
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education, but there is still a lack of knowledge about what
humanism is and what humanizing medicine means.
The implementation of the curricular guidelines for
training aims to contribute to the innovation and quality of
the pedagogical project, and should guide the curriculum of
the Medicine Undergraduate Course towards an academic
and professional profile of the graduates consistent with the
country's health policies.
In the area of medical training, it is observed that
this is a theme that still needs to be scientifically explored.
Considering that the institution UNIFAMAZ, presents as a
proposal an innovative curriculum, integrative,
interdisciplinary with the use of active methodologies and
includes in its curriculum an axis of medical humanities.
And in its guiding principles, objectives and graduate
profile the integrality and humanization of care as a
differential in medical training, it is necessary to evaluate
from the perspective of the actors to be trained their
perceptions of the relevance and effectiveness.
Thus, the scientific relevance of this study theme
is justified by the possible contribution to the Higher
Education Institution (HEI) in humanistic education in the
undergraduate medical course, with special attention to the
students' point of view.
III. OBJECTIVES
3.1 GENERAL OBJECTIVE
To evaluate, from the perspective of medical
students, their perceptions and knowledge regarding
humanistic training during medical school.
3.1 SPECIFIC OBJECTIVES
To interpret how the student considers the
relevance of the Medical Humanities axis in the physician's
education.
To analyze the degree of knowledge of the students
about the humanistic formation of the physician
To identify, from the students' point of view, the
importance of humanized health care.
IV. MATERIALS AND METHODS
4.1 TYPE OF STUDY
This is a quantitative and qualitative exploratory
research in the strict methodological sense of keeping as its
focus, the object of study. The quantitative research is
significant because it will help to characterize the intensity
and degree of ownership inherent to the object. The
qualitative study enables the analysis of individual and
collective information, in categories and topics, allowing a
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broader understanding. For Oliveira (2008, p. 58), these study, transcribed into the LibreOffice® program, preparing
two types of approach are not mutually exclusive, since, in the corpus for data processing. The processing of the corpus
opting for qualitative research, one can resort to quantitative content was done through the software IRAMUTEQ
data for a better analysis of the theme or vice-versa. (Interface de R pour analyses Multidimensionnelles de
4.2 UNIVERSE AND SAMPLE Textes et de Questionneires) version 0.7 alpha2
(CARMAGO; JUSTO, 2013).
For the development of the research considering its
objective was made with the students of the Medical course Among the possibilities of analysis by
of UNIFAMAZ, enrolled in the first semester of 2019. IRAMUTEQ, we chose the analysis of similarity and word
Students from the second to tenth periods participated. The clouds, since the similarity produces graphics that allow the
choice was intentional to meet the research objective and identification of the distributional principle that concerns
achieve diverse testimonies, involving students who studied the possibility of lexical units occurring in combinations
Medical Humanities and students who have advanced and with others. The cloud analysis, on the other hand, starts
are in practice in health settings. from the premise of how words are organized and grouped
graphically, taking into account their frequency of
Chart 1 - The research universe
appearance, originating from the text corpus.
Participants Universe Sample The data obtained through the software processing
2 101 20 were analyzed by the researchers, and were interpreted and
3 55 10 discussed in light of the theory of social representations and
literature on the subject. The answers were transcribed and
4 83 16 submitted to the methodological and theoretical processing
5 79 14 of the findings in the light of the referential. The Informed
6 44 08 Consent Form (Appendix C) requested permission to record
the questionnaires.
7 41 08
4.6 ETHICAL ASPECTS
8 41 08
The research project respected the precepts of the
9 38 06 Declaration of Helsinki and the Nuremberg Code, following
10 70 14 the determinations of Resolution 466/2012 of the National
Health Council and within the limits of the Code of Medical
Total 552 104
Ethics, and submitted the approval of the Research Ethics
Source: Medical course coordination/February/2019 Committee (CAAE: 099019.2.0000.5701). It complied with
the guidelines described in the Informed Consent Form. The
researchers signed a term of commitment (APPENDIX D)
4.3 LOCATION
as did the teacher responsible for the group's orientation
The research was carried out at the Centro (APPENDIX E). To participate in the research, the students
Universitário Metropolitano da Amazônia (UNIFAMAZ), signed an Informed Consent Form that guaranteed the
located at Avenida Visconde de Souza Franco, 72, Bairro confidentiality of the information and that the informant
Reduto, in the city of Belém-PA, 66053-000 (APPENDIX would not be identified in the final draft of the research
A). report (Appendix C).
4.4 PERIOD
Data collection was conducted in the month of V. RESULTS AND DISCUSSION
April 2019.
The examination of the questionnaires generated
4.5 DATA COLLECTION INSTRUMENTS two categories of analysis: 1) subjective and 2) objective.
As an instrument of data collection the structured 5.1 SUBJECTIVE CATEGORY
questionnaire was used (APPENDIX B) that made it
The main findings in this category, referring to
possible to obtain information about expectations, collect
medical humanization, the relevance of the medical
information from a large number of people in a relatively
humanities axis for the formation of physicians, and
short space. According to Oliveira (2008, p. 83), the
relevant topics not covered in the axis, were organized by
application of a questionnaire defined as a technique to
means of a table that indicates the number of the
obtain information about feelings, beliefs, expectations that
questionnaire applied to UNIFAMAZ students, and are in
the researcher wants to record to meet the objectives of his
their entirety in the work's file bank (Chart 2).

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Beltrão and Soares International Journal of Advanced Engineering Research and Science, 10(3)-2023

Table 2 - Characterization of the answers to the questionnaires, subjective, applied to students from the 2nd to the 10th
period of UNIFAMAZ, in which 104 questionnaires were applied. Legend of the code AL: student, 01: number of the
student's questionnaire.
Code Part of the research participants' reports (text corpus)
AL_01 Good doctor-patient relationship

AL_02 Friendliness. The doctor was very nice. It helps in the spirit. Just to have empathy. To understand the patient's side
and not just the professional.
AL_03 It is having empathy for others. Although not so often, there have been doctors who have made me feel welcome
and trust them. It directly implies in the patient's adherence to treatment, as well as feeling welcomed. Yes, because
we must be human regardless of the conditions we are exposed to. The human being has the ability to change the
environment he or she is in, as long as he or she sets out to do so.
AL_04 Treating the neighbor or the patient with a human eye, with empathy, taking a considerate care, being patient with
the patient's "agony". The doctor was attentive, patient, and human. The psychological aspect interferes in the
evolution of the pathology. It depends only on the doctor's will. It showed us the importance and the relevance of
this theme for the formation. How to deal with adverse situations in the day to day routine of a doctor who works
in the public health system.
AL_05 It's about having empathy with the patient. I didn't get it. Psychological. Because it depends on the average. It
helps to treat people and not of illness. I can't identify.
AL_06 It is empathy. It involves the doctor looking at the patient and not just seeing the disease, but the sick human being.
It increases adherence to treatment. Even in an unfavorable environment, empathy must exist. It is important for
our training as health professionals. The mental health of medical students.
AL_07 Medical humanization is a broad theme that involves biopsychosocial and environmental characteristics aimed at
the care of a human being, where focused care makes the difference in a good doctor-patient relationship. Centered
care with a good doctor-patient relationship makes the patient trust the medical conduct more.
AL_08 It is the search for proper medicine.
AL_09 It is medical care that is focused on the person, rather than only on pathology. Indigenous care is important because
it presents several situations that are relevant to medical training.
AL_10 Palliative care, elderly care.
AL_11 It is seeing the patient, before the disease. The doctor was concerned about me, not only about the disease, it is
not always the physical disease that is making the patient sick. Humanization does not depend on technology, but
on character. It is relevant because it reminds the students of their humanity and that of the patients. I have no
suggestions
AL_12 It is the service that uses care, well-being, and attention with a biopsychosocial outlook.
AL_13 It's a friendlier interaction towards the patient, not only dealing with the disease, but all their anxieties surrounding
the health-illness process. Maximum attention from the doctor towards me. For in most cases the patient just needs
a word of comfort for his problem. That is the least that is expected of a consultation. PBL teaching, is giving us
the experience that our professors did not have in the academic forefather. Everyone that I thought was important
was covered.
AL_14 It is the ability to be sensitive, to deal with other people's illnesses, and to know how to treat and dialogue with
the patient in a patient and caring way. Yes, it is extremely necessary to make us exercise from the beginning the
importance of humanized care and its benefits for patient and professional. Deepening in follow-up, preventive
care for the LGBT public
AL_15 It is the perception of the health professional about the intrinsic aspects of the individual, making it possible to
provide individualized care that is sensitive to the needs of each individual. It enables reflection and preparation
for actions or situations that may occur in the exercise of the medical profession.

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Beltrão and Soares International Journal of Advanced Engineering Research and Science, 10(3)-2023

AL_16 Medical humanization is patient-centered care. It's turning to the patient and not to the disease. When I was well
attended, by a doctor who looked me in the eye. It can help in the good prognosis of patients. This depends on the
doctor and his training. It is an axis that teaches us to see the patient with other eyes. There is no theme.
AL_17 It is looking at the patient with sensitivity, ethics and respect, always trying to seek the best and comfort for the
family and patient. The doctor was patient, attentive, and looked at me as a whole and not just as what I was
looking for. It makes it possible to get to know the patient better and then look for ways to speed up the healing
process. Unfavorable environments make humanized care difficult because it consumes the professional. Medical
Humanities is relevant for medical students because it allows them to reflect and teach about daily issues in the
life of a doctor. Therefore, with medical humanities we can learn about patients' rights, ethics, and get the best
management of patients and families. All the main points are covered in medical humanities, so I can't see if there
are others so important that have not been covered in the classroom.
AL_18 Medical humanization is the process that all doctors need to use as a basis in their practice, seeking to be as
accessible as possible to the patient. The doctors who treated me didn't give me the attention I needed. I believe
that humanized care promotes adherence to treatment and ends up influencing the professional's conduct. I believe
that contact with the discipline during graduation promotes familiarization and more effective learning.
Source: Part of the data obtained from the questionnaires applied. * The data inserted in the work are not in full, however, all
the statements are in a database.

In this category, the similarity analysis and word
cloud was performed through IRAMUTEQ, i.e., the set of
texts from the transcription of open-ended questions from
the questionnaire was analyzed, in which a list of
semantically identical words was generated, and their
relative frequencies were presented in the text corpus, and a
word cloud with central and peripheral terms was generated,
with the central and larger ones being the most relevant in
the text corpus. The words 'Patient' and 'doctor' were the
central terms, while the peripheral terms were 'humanized',
'professional', 'care', 'relationship', and 'form'. The words
'empathy', 'relationship', 'compliance', 'humanization',
'humanity', 'care', 'comfort', 'help', 'respect', and 'treatment'
were derived from the central term 'patient'. Derived from
the central term 'doctor', the related peripheral terms were
'attend', 'approach', 'medicine', 'social', 'neighbor', 'sick', and
'depend' (Figure 1).
Thus, the good 'doctor-patient' 'relationship' can be
built in a 'humanized' and 'empathetic' way, by the 'axis' of
Medical Humanities, which promotes the 'formation' in an
'important' way, 'developing' 'skills' in order to influence the
'care' in a 'caring' way, through the 'look' of the 'doctor'.
Moreover, the 'patient', in great majority, does not adhere to
the 'treatment' against a certain 'disease', thus diminishing
the 'health' and the 'importance' of this one, influencing in a
negative way the credibility of the medical care coming
from a lack of 'condition' to 'influence', 'respect' the 'patient',
determining the true form of the humanistic 'process' of
care. In the second main derivation of figure 1, in which the
word "doctor" is taken as the central secondary word, it is
preceded by the word "humanity", since, for the
"humanization" to occur, it is necessary the "formation"
with information to avoid situations of distancing the doctor
from "social" problems, for example.
Contemporarily, the doctor-patient relationship
has been focused as a key aspect for the improvement of the
quality of the health service and unfolds in several
components, such as the personalization of the assistance,
the humanization of the assistance and the right to
information (ARDIGÒ, 1995), treated through themes as
the degree of satisfaction of the user of the health service
(ATKINSON, 1993; WILLIAMS, 1994; GATTINARA, et
al, 1995; DUNFIELD, 1996; ROSENTHAL; SHANNON,
1997), the counselling - the counseling (BERT;
QUADRINO, 1989), the doctor-patient communication
(BRANCH et al., 1991; WHO, 1993), the suffering of the
patient and the purpose of biomedicine (CASSEL, 2007)
and the informed consent (SANTOSUOSSO, 1996).

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Beltrão and Soares International Journal of Advanced Engineering Research and Science, 10(3)-2023

Fig.1 - Similarity analysis between the vocabularies. Belém-Pará-Brazil, 2019.

Source: IRAMUTEQ 0.7 alpha2 data processing.

Another important factor shown in the third branch
of the clockwise direction in Figure 1, the word 'disease',
'health' and 'treat', which is interpreted by the biomedical
conception as a deviation of biological variables from the
norm. This model, based on a mechanistic perspective,
considers complex phenomena as constituted by simple
principles, i.e., cause-effect relationship, Cartesian
distinction between mind and body, analysis of the body as
a machine, minimizing social, psychological, and
behavioral aspects. If, on the one hand, based on these
principles, important transformations have been achieved
since the 19th century, such as the birth of the clinic,
Pasteur's germ theory, and even the recent successes in
genetics, immunology, and biotechnology studies; on the
other hand, the human, experiential, psychological, and
cultural dimensions of the disease have been neglected.
When it comes to verbal and non-verbal communication
patterns, as well as the variety of communicational patterns,
many problems arise in the doctor-patient relationship: a)
the doctor's misunderstanding of the words used by the
patient to express pain, suffering; b) the lack or difficulty in
transmitting adequate information to the patient; c) the
patient's difficulty in adhering to treatment (HELMAN,
1994).
With all of this mentioned, it should be understood
that through the analysis of similarity, the real need for the
importance of the axis of medical humanities for medical
students is evident, which should follow a social and
psychological approach, in which the academy is one of the
main promoters for the propagation of humanized care.

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Although most students and professors recognize that all
medical disciplines, in practice, need to refer to humanistic
knowledge in order to in fact care for the patient in
integrality, the teaching of humanities has been disregarded
from the central scope of medicine and meets with
resistance (CAPRARA; FRANCO, 1999).
Figure 2 presents the word cloud derived from the
text corpus obtained in the present investigation,
remembering that the vocabulary words were organized
according to the frequency they appear in the text processed
by IRAMUTEQ (CARMAGO; JUSTO, 2013).
Fig.2 - Word cloud of the text corpus. Belém-Pará-Brazil,
2019.
Source: IRAMUTEQ 0.7 alpha2 data processing.
In what is related to the vocabulary words and their
absolute frequencies, within the text corpus of the students'
interview, obtained evidence of the main terms: Patient
(frequency of 86), physician (frequency of 70), care
(frequency of 44), empathy (frequency of 48), professional
( frequency of 34), important( frequency of 35), human
(frequency of 33), humanized (frequency of 25),
relationship (frequency of 17), physical (frequency of 17),
health (frequency of 25), treat (frequency of 15), treatment
(frequency of 12), In the vast majority of questionnaires
these words considered high frequency, such as empathy,
doctor and patient, were exposed by students, correlated
with the true meaning for him of a good humanized care. A
fragment taken from the AL_32 questionnaire, according to
Chart 1, makes this premise explicit:
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"It is the ability of the
physician to have empathy and
understand the patient, the
patient in a biopsychosocial
way" (Student 32).
In addition, another intrinsic component of the
semantic words in the questionnaires is the patient as a
'biopsychosocial' being. Given this fact, the "axis" of
"medical humanities" is an important vehicle of the real role
of the thematic axis in question, the word "care", which is
often mentioned in the questionnaires conducted by
students. In this context, it is worth demonstrating this view
in the questionnaire, AL_34:
"The medical humanities axis
enables the development of
empathy and the training of
emotional skills for improved
care" (Student 34).
On the other hand, the word 'holistic' is also
focused on, by means of statistical data and through highly
cited arguments, and most of them correlate it with
humanized care, as in the example of questionnaires AL_38
and AL_42:
"Treating the patient well,
especially with respect and
holistically" (Student 38).
"It's the doctor-patient
variation, it's the doctor's way
of looking at the patient as a
whole, closer" (Student 42).
As for the checks of holisticity, in face of medical
practices, it is founded on philosophical principles that
value efficiency, technique, and scientific knowledge, and
deny any possibility of a metaphysical knowledge,
deploying scientific realism. According to Almeida (1999),
when studying the human body, Cartesianism produces a
mechanism of forgetfulness that prevents us from mixing
and confusing ourselves with the body, it creates the image
that the body is a machine.
In fact, to be a doctor who recovers people not only
from illness, but also from pain, fear, and helplessness, one
must be able to move from intention to gesture that
transforms the procedure into a medical act. To train
professionals with this level of greatness, it is necessary to
develop reason and sensitivity in medical training, the
contribution of the humanities to medicine (RIOS;
SCHRAIBER, 2014).
It can be stated, as revealed by the word cloud
represented by Figure 2, that the term 'Physician' and
'Patient', the most cited and central word, can be considered
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Beltrão and Soares International Journal of Advanced Engineering Research and Science, 10(3)-2023
the one that best represents the scientific evidence that
medical humanity is not centered only on being a physician,
but, in fact, doing medicine for people in an integrative way.
In the intermediary periphery of Figure 1 and Figure 2, the
link between the words ethics and patient was evidenced.
Related to the category Physician, which is one of the main
links, as already mentioned, for a humanized care, since
there is a possibility that medical education leaves the
physician as the center and not the patient, and this
relationship is based on an ethical conduct, which is the
third semantic word that lists this link, as shown and cited
by the questionnaire, AL_17:
"Medical humanities is
relevant for medical students
because it allows reflection
and teaching about daily issues
in the life of a doctor.
Therefore, with medical
humanities we can learn about
patients' rights, ethics, and get
the best management of
patients and families" (Student
17).
Thus, the analysis of the importance of the medical
humanities axis by the students has been breaking the
perspectives of society: from pre-logical, fragmented
reasoning, to logical, formal reasoning. This becomes clear
in the questionnaire study in question, specifically to the
students who had contact with the medical humanities axis,
which materializes a thought of the principle and perception
of the students before this fact, in this case; the axis. The
subject is active in the process of appropriation of objective
reality (MOSCOVICI, 1990).
Diagram 1 - Diagram of responses to the questionnaire. Belém-Pará-Brazil, 2019.
Source: Questionnaires distributed to UNIFAMAZ students.
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Empathy is the most present characteristic in the
students' discourse, both for the definition of humanization
and regarding the quality of the doctor-patient relationship
in which empathy is a multidimensional construct (in the
cognitive, behavioral and affective spheres), which acts as a
resource for the regulation of social life, modified by culture
and learning (FALCONE, et al., 2018).
"It's having empathy with the
patient" (Student 5).
In this way, the conception of representations
comprises a set of concepts, statements, and explanations
through which the interpretation and even the construction
of realities is carried out (JODELET, 1990).
Therefore, it should be understood that medical
humanization has an imagetic character and the property of
leaving interchangeable sensations, ideas and conceptual
games, giving an autonomous and individualistic character,
as well as a collective character to each group or individual.
As for example in the doctor-patient relationship, in which
each group and each individual constructs a relative
perception of the subject.
5.2 OBJECTIVE CATEGORY
In addition, objective questions were elaborated in
the questionnaire, in which Diagram 1 and Diagram 2 and
their respective interpretations of the questions mentioned
by the importance of humanization and insertion of
humanities curricular units in the curricular structure of
medical education in Brazil are outlined. Among them was
the question about the perception of the student regarding
the medical humanities axis for their training.
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Beltrão and Soares International Journal of Advanced Engineering Research and Science, 10(3)-2023

Diagram 2 - Diagram of responses to the questionnaire. Belém-Pará-Brazil, 2019

Source: Questionnaires distributed to UNIFAMAZ students

Diagrams 1 and 2 show the relevance of this axis for the
students, in which 91% of the answers were "Yes", when
asked: "Do you think the teaching of medical humanities is
necessary for medical training? The perspective of the
students in taking up the idea that the doctor-patient
relationship is a key element in health care, humanization
would be an element of relational quality, because it
proposes a communicational process supported by dialogue.
As these are skills that can be taught and learned, its
Diagram 3 - Diagram of responses to the questionnaire. Belém-Pará-Brazil, 2019.
development is recommended in medical schools
(CAPRARA; FRANCO, 1999).
However, students often see them as uninteresting
and dispensable, in part because, although fundamental to
good medical practice, they are often addressed
superficially in medical curricula. Diagram 3 shows
students' responses when asked about the application of
humanized medicine in unfavorable working conditions.

Source: Questionnaires distributed to UNIFAMAZ students.

According to Diagram 3, students associate non-
humanized practices with the lack of structure of the
environment, which should be focused on care. When faced
with the precariousness of resources for their work - few
beds, few professionals in the health team, fewer
technological resources than desirable, among others.
Finally, the students were asked about their perception of
patient healing and the correlation with humanized medical
care.
The humanization of care is part of a larger plan to
achieve more efficiency, results, and possibilities for cure in
health care facilities. When there is integration and more
direct communication between patients and service users,
health professionals, and the managers of hospitals, clinics,
and medical institutions, a more humanized bond is created
among all instances.
In this way, more respect and recognition is
established between the parties involved, which only tend
to reflect in a more effective care to those in need.
Humanizing care means considering the existential needs of
that person, attending them with solidarity, and being able
to comfort them (VENTRIX, 2019).

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Beltrão and Soares International Journal of Advanced Engineering Research and Science, 10(3)-2023
Diagram 04 - Diagram of responses to the questionnaire. Belém-Pará-Brazil, 2019
Source: Questionnaires distributed to UNIFAMAZ students
VI. CONCLUSION
In view of what was evidenced by the present
study, the insertion of the teaching of humanized medicine
in the undergraduate course exerts on the student and future
professional a reflective, motivational, and guiding power
about the subsequent medical practice.
The construction of the subject is a multifactorial
process that receives cultural, social, affective, and
sociological influences. Therefore, during medical
graduation, students are unique subjects, the result of a
series of processes that are not known. Humanized medical
education is an addition to the processes of subject
formation, who needs to be stimulated to observe the patient
from a perspective that is often different from the reality in
which he/she lives, making him/her a humanistic, critical,
reflective and ethical professional, with the capacity to act
at different levels of health care.
Empathy, understood in different ways, according
to the view of different authors, stands out as a
communicational skill that allows the understanding of the
other and the communication of this understanding, was
used by most of the students participating in this research to
characterize humanized patient care, showing once again
that learning this humanized form of medicine is also a tool
used in medical practice to see the patient in a transcendent
way, taking professional conduct to a sphere that goes
beyond the logical and disease-centered thinking.
Given the answers obtained in the application of
the questionnaires and already reported in the analysis of the
study, it is concluded that the students consider the teaching
of medical humanities important for their professional
growth and performance, because they believe that the axis
led them to reflect on daily issues of medical life, patient
care, a differentiated view of illness interfering in the
healing process, besides the motivational sense in producing
a more humane and ethical medicine.
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